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Individual

DR. JARED TODD GRIFFIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 475-1700
(706) 475-1787
Mailing address
1500 OGLETHORPE AVE, SUITE 600A, ATHENS, GA 30606-2179
(706) 475-4933
(706) 208-8259

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
057469
GA
207RI0011X
Interventional Cardiology Physician
Primary
057469
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00335669
RR MEDICARE
GA
05
035374241A
GA
05
035374241C
GA
05
035374241D
GA
05
035374241E
GA
05
035374241F
GA
05
035374241G
GA
05
035374241H
GA
05
035374241I
GA
05
035374241J
GA
01
933586
BLUE SHIELD
GA
01
GRP891
GA MEDICARE GRP NUMBER
GA
Enumeration date
06/28/2006
Last updated
01/05/2015
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